Micro-ultrasound tissue echogenicity predicts prostate cancer grade

Area of Science:

• Urology
• Radiology
• Oncology

Background:

• Prostate cancer diagnosis relies on imaging and biopsy.
• Micro-ultrasound (micro-US) offers high-resolution imaging for prostate assessment.
• Lesion echogenicity is a potential imaging biomarker for prostate cancer.

Purpose of the Study:

• To investigate the association between micro-US lesion echogenicity and prostate cancer presence and grade.
• To determine if echogenicity can improve prostate cancer risk stratification.

Main Methods:

• Prospective analysis of 229 prostate lesions from 181 men undergoing micro-US-guided biopsy.
• Lesions were classified as hyperechoic, isoechoic, or hypoechoic relative to the central zone.
• Correlation with Grade Group (GG) of cancer and apparent diffusion coefficient (ADC) values.

Main Results:

• Higher Grade Group prostate cancer (GG≥2) detection rates increased with decreasing echogenicity (22% hyperechoic, 56.2% isoechoic, 62.4% hypoechoic).
• Hypoechoic lesions showed a higher proportion of GG≥3 cancers.
• Apparent diffusion coefficient (ADC) values decreased with echogenicity, indicating higher cellularity.

Conclusions:

• Lesion hypoechogenicity on micro-US is strongly associated with higher-grade prostate cancer.
• Echogenicity correlates with tissue cellularity, as indicated by ADC values.
• Incorporating echogenicity into the micro-US PRI-MUS framework may enhance prostate cancer risk stratification.